New Dental Patient Intake Form

The New Dental Patient Intake Form is a comprehensive onboarding form for dental practices, designed to collect everything your team needs before a patient’s first appointment – all completed and e-signed online, before they even walk through the door.

What Information Does the Form Collect?

• Patient Information – full name, date of birth, contact details, and emergency contact
• Dental & Medical History – current conditions, past procedures, and relevant health background
• Medications & Allergies – current medications, known allergies, and adverse reactions
• Insurance Details – provider, policy number, and coverage information
• Treatment Consent – patient acknowledgment and legally binding e-signature

Why Use a Digital Dental Intake Form?

• Eliminate paper forms and front-desk bottlenecks
• Ensure complete, accurate records before the appointment begins
• Flag health risks, contraindications, and allergies in advance for safer, more personalized care

Who Is This For?

Dental clinics, family dentistry practices, orthodontists, oral surgeons, and any oral health specialist looking to modernize their patient onboarding process.

Send the form with FillFaster to new patients before their first visit – they fill it out and e-sign from any device, and the completed form is ready for your team the moment they arrive.